Organization
EAT MOVE GROW LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAURA OLSONOSKI OTD, OTR/L (OWNER)
(952) 356-6778
Entity
Organization
Contact information
Practice address
3031 S RUSSELL ST STE B, MISSOULA, MT 59801-8523
(406) 396-4130
(406) 797-5008
Mailing address
3031 S RUSSELL ST, MISSOULA, MT 59801-8523
(952) 356-6778
(406) 315-4421
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OTP-OT-LIC-3971
MT
Other
Enumeration date
09/13/2016
Last updated
12/21/2022
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